CT和MRI对颅内鞍区肿瘤的诊断意义比较

Comparison of CT and MRI in the diagnosis of intracranial sellar tumors

目的探讨计算机断层扫描(CT)和磁共振成像(MRI)对颅内鞍区肿瘤的诊断意义。方法选取我院2015年2月~2017年2月收治的68例颅内鞍区肿瘤患者,对所有患者均进行CT、MRI平扫及增强扫描。分别记录其CT、MRI平扫及增强扫描的影像学特征,比较两种诊断方法的检出情况及准确率。结果 CT和MRI在肿瘤类型的检测方面差异无统计学意义(P>0.05)。CT扫描有3例胶质瘤误诊为垂体腺瘤,2例颅咽管瘤误诊为胶质瘤,1例生殖细胞瘤误诊为胶质瘤,7例漏诊;MRI扫描有1例颅咽管瘤误诊为生殖细胞瘤,1例生殖细胞瘤误诊为胶质瘤,1例漏诊。CT与MRI的漏诊率与误诊率比较差异无统计学意义(P>0.05)。CT的检出率为89.71%(61/68),与MRI的98.53%(67/68)比较,差异无统计学意义(P>0.05);但MRI的检出准确率明显高于CT(97.06%vs.88.24%)(P<0.05)。结论 CT可显示靶区肿瘤的高密度与钙化程度,MRI可提供多方位清晰图像、定位准确、且敏感度高;两者各有优劣,但联合使用能有效提高颅内鞍区肿瘤的诊断准确率。

Objective To investigate the diagnostic significance of computed tomography （CT） and magnetic resonance imaging （MRI） in the diagnosis of intracranial sellar tumors.Methods From February 2015 to February 2017,68 patients with intracranial sellar tumors were selected from our hospital.All patients were provided with CT and MRI plain and enhanced scanning.The imaging features of CT,MRI plain and enhanced scanning were recorded respectively,and the detection and accuracy of the two methods were compared.Results There was no significant difference in the detection of tumor type between CT and MRI （P〉0.05）.3 cases of glioma were misdiagnosed as pituitary adenoma,2 cases of craniopharyngioma were misdiagnosed as glioma,and 1 case of germ cell tumor was misdiagnosed as glioma by CT scanning with 7 cases of missed diagnosis.In MRI scanning,1 case of craniopharyngioma was misdiagnosed as germ cell tumor,1 case of germ cell tumor was misdiagnosed as glioma.Only 1 case was missed diagnosis.There was no significant difference in missed diagnosis rate and misdiagnosis rate between CT and MRI （P〉0.05）.The detection rate of CT was 89.71% （61/68）,there was no significant difference,compared with 98.53% （67/68） Of MRI （P〉0.05）.But the accuracy of detection by MRI was significantly higher than that by CT （97.06% vs. 88.24%） （P〈0.05）.Conclusion CT can show the high density and calcification of tumor in target area,and MRI can provide clear image and accurate location in high sensitivity.Both of them have advantages and disadvantages,and the joint application can effectively improve the diag- nostic accuracy of intracranial sellar tumor.